Abstract
BackgroundElderly minority patients are less likely to receive influenza vaccination and colorectal cancer screening than are other patients. Communication between primary care providers (PCPs) and patients may affect service receipt.MethodsEncounters between 7 PCPs and 18 elderly patients were observed and audiotaped at 2 community health centers. Three investigators coded transcribed audiotapes and field notes. We used qualitative analysis to identify specific potential barriers to completion of preventive services and to highlight examples of how physicians used patient-centered communication and other facilitation strategies to overcome those barriers.ResultsSharing of power and responsibility, the use of empathy, and treating the patient like a person were all important communication strategies which seemed to help address barriers to vaccination and colonoscopy. Other potential facilitators of receipt of influenza vaccine included (1) cultural competence, (2) PCP introduction of the discussion, (3) persistence of the PCP (revisiting the topic throughout the visit), (4) rapport and trust between the patient and PCP, and (5) PCP vaccination of the patient. PCP persistence as well as rapport and trust also appeared to facilitate receipt of colorectal cancer screening.ConclusionSeveral communications strategies appeared to facilitate PCP communications with older patients to promote acceptance of flu vaccination and colorectal cancer screening. These strategies should be studied with larger samples to determine which are most predictive of compliance with prevention recommendations.
Highlights
As they approach age 65, many Americans eagerly anticipate the day when they can have more leisure time
For those entrusted with safeguarding the Nation’s health, monitoring the health of the American people is an essential step in making sound health policy and setting priorities for research and programs
Health, United States presents trends and current information on measures and determinants of the Nation’s health. It identifies differences in health and health care among people of differing races and ethnicities, genders, education and income levels, and geographic locations, and it shows whether these differences are narrowing or increasing
Summary
Discharges, days of care, and average length of stay in non-Federal short-stay hospitals, according to selected characteristics: United States, selected years 1980–2003 . Hospital expenses, according to type of ownership and size of hospital: United States, selected years 1980–2003. Health insurance coverage for persons 65 years of age and over, according to type of coverage and selected characteristics: United States, selected years 1989–2003 . Health maintenance organizations (HMOs) and enrollment, according to model type, geographic region, and Federal program: United States, selected years 1976–2004 . Medicare beneficiaries by race and ethnicity, according to selected characteristics: United States, 1992 and 2001 . Hospital care per capita expenditures, by geographic region and State: United States, selected years 1991–98 . Hospital care per capita expenditures, by geographic region and State: United States, selected years 1991–98 . . . 405
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